the scalp-ear-nipple (seN) syndrome is an autosomal-dominant disorder characterized by cutis aplasia of the scalp and malformations of breast, external ears, digits, and nails. Genetic analyses have shown that the disease is caused by missense mutations of the KCTD1 protein, although the functional/ structural basis of seN insurgence is hitherto unknown. With the aim of unravelling the molecular basis of the SEN syndrome associated with KCTD1 mutations we here expressed and characterized several disease causing mutants. A preliminary dissection of the protein provides insights into the role that individual domains play in KCTD1 stability. The characterization of SEN-causing mutants indicates that, although the mutation sites are located in distant regions of the BtB domain or of the pre-BtB region, all of them are unable to interact with the transcription factor AP-2α, a well-known KCTD1 biological partner. Notably, all mutations, including the one located in the pre-BTB region, produce a significant destabilization of the protein. The structural role of the pre-BTB region in KCTD1 and other proteins of the family is corroborated by its sequence conservation in orthologs and paralogs. Interestingly, seNcausing mutations also favor the tendency of KCTD1 to adopt structural states that are characterized by the ability to bind the β-amyloid fluorescent dye thioflavin T. The formation of aggregation-prone species may have important implications for the disease etiology. Collectively, these findings provide an intriguing picture of the functional and structural alterations induced by KCTD1 mutations that ultimately lead to disease. Members of the KCTD (Potassium Channel Tetramerization Domain) family represent an emerging class of proteins that play a key role in fundamental physio-pathological processes 1-16. Investigations carried out in the last decade have highlighted analogies and differences among different members from both the structural and the functional points of view. Although the biochemical activities of these proteins are still somehow obscure, the biological characterizations of KCTDs have disclosed their crucial roles in highly diversified processes such as protein ubiquitination and degradation 13,15-17 , binding and modulation of the GABA B receptor 18-22 , autophagy 23 , adipogenesis 24 (Pirone et al. unpublished results), sleep homeostasis 25,26 and metabolic homeostasis 27. Not surprisingly, they are also involved in the insurgence of severe pathological states that include epilepsy, cancer, obesity, and skin diseases. A number of these pathologies are generated by mutations of KCTD proteins whose structural interpretations have been scarcely investigated 28,29. In particular, the allelic deletion of human KCTD11 at chromosomal location 17p13.2 has been found in medulloblastoma 30,31 whereas single nucleotide polymorphisms (SNPs) of KCTD10 (i5642G > C and V206VT > C) are associated with altered concentrations of HDL cholesterol in subjects with high levels of carbohydrate intake 9,32. It has been...